A recent article published in Modern Healthcare highlights how CMS interpreted a rule within the healthcare reform law that is putting healthcare providers at greater financial risk. To summarize, healthcare providers could incur unreimbursed costs for services delivered to a consumer that has discontinued paying their insurance premium. See below for a detailed description of this scenario.
It appears that the business of delivering healthcare to a community is becoming more financially challenging. When you consider the increasing number of patients looking for care, reimbursement rates declining, no limits on malpractice suits and increasing regulatory burdens, it should be no surprise that in the future we see more healthcare providers filing for bankruptcy, looking for a financial bailout, selling their business, delivering limited services or discontinuing operations.
Here is the scenario that puts healthcare providers at greater financial risk due to CMS’s